How to diagnose and treat a frozen’ shoulder

Sunday

Jul 22, 2018 at 12:01 AM

Question: I woke up with shoulder pain three weeks ago and could barely lift my arm. Now my shoulder is very stiff and painful. It’s difficult for me to get dressed and reach my back pants pocket. What should I do?

Answer: You have described a frozen shoulder. The medical term for this condition is "adhesive capsulitis." It often presents first with pain that makes it difficult to raise your arm. Then, it is marked by a progressive loss of range of motion and function.

This loss of range of motion occurs because the thin lining of the shoulder joint — the capsule — becomes thickened and loses its compliance. This condition is more common in middle-aged women and has a more severe presentation in diabetics.

Most cases occur without preceding trauma or an identifiable cause. Prompt evaluation is very important.

Immobilization is a very poor idea, as this can allow the loss of function to be accelerated. Your surgeon will typically try oral anti-inflammatories, a cortisone injection and physical therapy. However, in rare cases when non-operative treatment is not successful, arthroscopic (minimally-invasive) release of the thickened capsule and a manipulation under anesthesia is very successful at restoring range of motion and eliminating pain.

Dr. Simovitch was involved in the initial implantation and FDA investigation of the reverse shoulder replacement while at Duke University Medical Center and has published landmark papers since guiding their successful implantation. He performs more than 150 shoulder replacements per year.